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Lupus, Vol. 6, No. 7, 613-615 (1997)
DOI: 10.1177/096120339700600710

Systemic lupus erythematosus associated with transverse myelitis and Parkinsonian symptoms

H. Osawa

Second Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan

H. Yamabe

Second Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan

M. Kaizuka

Second Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan

N. Tamura

Second Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan

S. Tsunoda

Second Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan

KI Shirato

Second Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan

K. Okumura

Second Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan

A 31-year old woman developed transverse myelitis after 10 years remission since she was first diagnosed as systemic lupus erythematosus. Although pulse methyl prednisolone resolved her myelitis, Parkinson-like symptoms developed subsequently after reduction of steroid. Treatments including apheresis did not improve her Parkinson-like symptoms such as rigidity, akinesia, impairment of speech and mask-like facial expression. Levodopa was effective as a symptomatic therapy. Orally administered cyclophosphamide eventually led her to remission and withdrawal from levodopa. Her clinical course and the absence of other possible causes prompted us to conclude that Parkinsonian symptoms as well as transverse myelitis may have developed as manifestations of central nervous system lupus.

Key Words: systemic lupus erythematosus • transverse myelitis • Parkinsonism


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